1. Make it worth doing. Until the fee for service reimbursement model goes away, the request to adopt any new technology by physicians is met with the question, “Is this a reimbursable service?” This is a sad but true state of reality. The good news is that even if it were reimbursable, the financial and medical benefits of the use of mobile apps for patients with chronic diseases will likely outweigh any shortcomings. The key to this is to demonstrate better financial and clinical outcomes of its use to organizations such as ACOs which would hopefully have the appropriate data collecting IT to demonstrate this. The fee for service model of healthcare in the USA is going away. Bundled and outcomes-based payment models are coming. However, these systems will not be in place fast enough for mHealth technologies to be adopted when they are needed most-right now. Sadly, reimbursement is connected at the hip (with regards to some technologies) to the FDA approval process whose guidance document is presently in limbo.
2. Make it a shared experience. Patients are likely to be receptive to following a medical app if prescribed by a physician. Patient adherence is likely to be higher when patients participate in shared decision-making and self-management. Patient-provider relationships improve when the patient has a larger role in the care process. Mobile health technologies can increase meaningful exchanges of data and communications which are more effective than the snapshot office visit. Physicians need to be made aware of the increasing roles and influence of organizations like the Society for Participatory Medicine and social media. They will realize the importance of shared decision-making and thus the effectiveness of digital health technologies by involving the patient.
3. Make it an important learning experience. Having new technologies thrust upon them in a guideline or mandate are usually met with skepticism (some of which is very healthy) by physicians. Mobile health technologies are here now for physicians to familiarize themselves with. They have the opportunity to show patients that they want to utilize tools which furnish them with data emanating from the patients themselves. This will be a shared learning experience for both physicians and patients which itself might improve the physician-patient relationship by learning from each other.
4. Make it simple. Electronic prescribing of medical apps is something which will revolutionize healthcare in many ways. Although in its early phases, this type of treatment will encourage the personalization of treatment by the physician prescribing a combination of monitoring and treatment regimens specific for a given patient. It will automate healthcare delivery away from larger hardware-based technologies. It will facilitate treatments away from hospitals and create home-based sub acute care as a healthcare delivery model.
5. Make it effective. Though not convincingly demonstrated yet, digital technologies as a whole will likely improve patient outcomes by personalizing care plans based on genetic and EHR data-mined information. Clinical trials do need to be presented to physicians, though they need not be the classic randomized control trials. Crowdsourced health studies have demonstrated the power of subject-organized or genome-based studies. Clinical studies need to be presented at professional society meetings.
This is a great, and very informative post.
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